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Outpatient TKA Shift Calculator

    CMS’s decision to remove total knee replacements from the inpatient-only list allows for Medicare reimbursement of these procedures in the hospital outpatient department. While this decision has been followed by a rapid increase in Medicare joint replacements being performed outpatient across the country, the impact of CMS’s decision will vary by program depending on the case mix of the market.

    Use the outpatient TKA shift calculator to estimate the risk of your inpatient Medicare TKA volumes shifting outpatient. The calculator provides volume and financial projections based on the national ratio of TKAs to MS-DRG 470 volumes sized to a given program, and accounts for patient complexity and common clinical exemption criteria.

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